Abstract:

Objective To figure out the relationship between lymphedema status and symptoms among breast cancer survivors. Methods Convenient and purposive sampling methods were used to recruit 224 participants who underwent axillary lymph node dissection. Circumferential limb measurement was used to confirm the lymphedema diagnosis and make sure the lymphedema status ； Breast Cancer and Lymphedema Symptom Experience Index （ BCLESEI ） was used to assess the symptoms experienced by breast cancer survivors. Results Among all 224 participants ，94 （ 42.0% ） of cases had no lymphedema ， while 46 （ 20.5% ） developed mild lymphedema and 84 （ 37.5% ） developed severe lymphedema. Significant differences in scores of symptom experience were found among groups （ P=0.017 ）； significant differences were found in the rate of arm swelling ， arm heaviness ， arm fatigue ， arm tightness ， arm firmness ， limited arm movement ， limited elbow movement and limited wrist movement between non鄄lymphedema group and mildlymphedema group. Conclusion Symptoms can exist in the early stage of lymphedema ， and number and severity of symptoms ， distress of symptoms will increase as the lymphedema aggravates ； symptom assessment may contribute to the early detection of lymphedema and guide the intervention.

Key words: Breast Neoplasms , Lymphedema , Signs and Symptoms , Early Medical Intervention

摘要： 目的 调查乳腺癌患者术后不同程度淋巴水肿发生状况及其相关症状情况，分析两者之间的关系。 方法 采用便利抽样及目的抽样方法，选择乳腺癌行腋窝淋巴结清扫术后患者 224 例， 采用肢体周径测量法判断淋巴水肿严重程度， 采用乳腺癌淋巴水肿症状体验指数（ Breast Cancer and Lymphedema Symptom Experience Index ， BCLE鄄SEI ）评估患者淋巴水肿相关症状体验。 结果 224 例患者中，无水肿 94 例（ 42.0% ），轻度水肿 46 例（ 20.5% ），重度水肿 84 例（ 37.5% ）。 轻度淋巴水肿患者的症状个数、症状严重程度及症状困扰总分高于无淋巴水肿患者（ P=0.007 ）；重度淋巴水肿患者的症状个数、症状严重程度及症状困扰总分高于轻度淋巴水肿患者（ P=0.017 ）。 轻度水肿患者的上肢肿胀、患肢沉重、患肢疲乏、患肢紧绷、患肢僵硬、手臂受限、 肘部受限、 手腕受限的发生率高于无水肿患者。 结论 淋巴水肿早期就出现相应症状，且症状体验随着水肿加重而越发严重。 关注患肢肿胀、患肢沉重等淋巴液积聚症状，可早
期发现淋巴水肿并给予早期干预，阻止或延缓水肿程度的进展。

关键词: 乳腺肿瘤, 淋巴水肿, 体征和症状, 早期医疗干预